e.g. mhealth
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Users completed the Depression Anxiety Stress Scale-21 (short version; DASS-21) [21] twice via an in-app, self-report questionnaire. The DASS-21 is a well-validated [22-24] measure comprising 3 scales, each with 7 items. Item responses were summed to create continuous scores of depression, anxiety, and stress symptom severity; higher scores indicated greater severity.
JMIR Form Res 2025;9:e71346
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Those aged ≥18 years who responded to the pretest and exhibited mild to moderate symptoms of depression, anxiety, or perceived stress were eligible for inclusion.
JMIR Form Res 2025;9:e71465
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For example, Akbar et al [45], using a wrist-worn smartwatch, observed that HRV-derived stress peaks corresponded with self-reported stress during work and after-hours EHR tasks, and Martinez et al [47] reported that HRV features were significantly but weakly associated with perceived stress. Kim et al [46], using a chest-strap sensor, demonstrated a bidirectional pattern, where lower HRV predicted higher perceived stress, and stress predicted HRV decreases within 10 minutes.
JMIR Form Res 2025;9:e68733
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Key to this innovation was focusing on stress in daily life [2] and how it contributed to health, well-being, and aging. Prior research on stress in adulthood focused primarily on major life events (eg, marriage, bereavement, and retirement) and their impacts on health and well-being [3]. In contrast, daily stressors (eg, minor everyday conflicts or irritations) [4,5] received much less attention but offered considerable promise for understanding contextual factors impacting life as it is lived.
JMIR Res Protoc 2025;14:e76453
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The psychological impact of the COVID-19 pandemic extended beyond burnout, encompassing a wide range of adverse mental health outcomes, including stress, anxiety, depression, inadequate sleep, posttraumatic stress disorder symptoms, and secondary trauma [10]. Anxiety, depression, stress, and burnout levels were notably higher among physicians and nurses than in other health care roles, consistent with findings from other systematic reviews [9,11].
JMIR Med Educ 2025;11:e70726
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The specific subset of variables used in this study, defined in conjunction with the study clinicians, includes recreational drug use and binge drinking (Table 1), symptoms of depression (PHQ-9) [23], anxiety (GAD-7) [24], personal and familial history of mental illness, adverse childhood experiences, suicidal thoughts and behaviors and self-harm (Columbia-Suicide Severity Rating Scale, C-SSRS [25]), and self-perceived stress (Perceived Stress Scale–4 [PSS-4]) (Table 2).
J Med Internet Res 2025;27:e72669
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When individuals are confronted with intense and prolonged uncertainty stress, it can have detrimental effects on their mental and behavioral well-being [18]. The COVID-19 pandemic is characterized by a high degree of uncertainty, as it emerged suddenly, spread rapidly, and then declined abruptly. These factors contribute to a significant level of uncertainty stress.
JMIR Form Res 2025;9:e74370
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The study also reported a significant increase in subjectively recorded stress levels during the clinical period; however, it did not assess the association between mean HR and subjective stress directly [33].
JMIR Form Res 2025;9:e67822
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We used physiological metrics (EDA, BT, and HR) to measure stress levels, implementing the pretrained random forest classifier, one of the most widely used machine learning techniques [50], and was developed by Hosseini et al [33]. The classifier was trained on the Affective Road dataset [51], optimized through grid search and cross-validation, and categorized stress into three levels: 0 (no stress), 1 (moderate stress), and 2 (high stress).
JMIR Serious Games 2025;13:e67623
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Supporting Police Well-Being Through an Adaptive Shift Management System: Co-Design Study
These stressors often lead to high rates of psychological stress, including anxiety and posttraumatic stress disorder [2]. High levels of stress among police officers have been linked to poor sleep quality, fatigue, malnutrition, long-term physical disabilities, sedentary lifestyles, impaired cognitive function, increased risk of cardiovascular disease, poor work-life balance, less family time, and mental health issues [3].
JMIR Form Res 2025;9:e69986
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